Narcs on the loose?

[KatieBell]

Just started a travel assignment at XYZ hospital. It's going pretty well, and I like the staff. Yesterday, however, I went into the med room, and found a syringe half full with a tubex of empty Morphine taped to it, with a patients name attached to it- sitting on the counter.

Of course I immediately tried to find the nurse who was taking care of the patient. My co-workers told me that it is common practice to leave this stuff on the counter.

I was really, rather...surprised.

Everywhere I have worked, the nurses have held on to the narcs they are using. They tape them to the back of their badges, or pin a plastic bag full of them to their scrubs, stick them in pockets...until the patient is DC's and we waste whatever is left...

Now, I don't want to be a nervous nellie, is it just me, or is this practice of leaving narcs laying out on a counter, just a little unsafe?

I'm not going to get into this habit, but I am wondering if there could be a problem for me with another nurses narcs that may or may not go missing!

[CrunchRN, ADN, RN]

Do it by the book or you will get hung out to dry eventually. Just do not take any chances. I have seen so many posts here where nurses have been censored by the BON even though they did not actually divert narcotics. It was this kind of practice that led to those problems. It is just not worth it.

[meownsmile, BSN, RN]

I would hope that narcs would be wasted with each dose given. Another reason besides those above is because if you "save" an unused portion of a tubex dose to give the next time the patient needs pain medication all it is doing is keeping the hospital from charging for that next injection. If there isnt a charge for that second dose, then there isnt a proper accounting of dollar charges and staff get to feel the bite. The pharmacy doesnt make their charges based on MAR documentation, its based on doses given (signed out). Thats why they log all pills in and out of pharmacy, ones that come back get credited. Injectables are the same way, if its not signed out each time its not charged for.

Consider if you held a wasted narc to give the rest later 80 times last year, and every nurse did that. That will take hundreds of thousands of dollars out of the facility coffers and your paycheck will eat it in the form of lower raises when facility income isnt meeting cost. The patient is charged the same amount for a 10mg MSO4 as they are for 1mg, but if you dont allow for the charge for each of the 1mg, by not signing out a dose that adds up. Give yourself an opportunity for a raise anyway.

At least thats the way its done in most facilities.